If you’re living with sleep apnea, you already know how important it is to take your condition seriously. But did you know that sleep apnea is connected to other health conditions? One of these conditions is pulmonary hypertension (PH), or high blood pressure in the arteries that carry blood from your heart to your lungs. Over time, pulmonary hypertension can strain your heart and cause serious complications.

Understanding the connection between sleep apnea and pulmonary hypertension can help you recognize symptoms early, ask your doctor the right questions, and take steps to protect your heart and lungs. In this article, we’ll explore how these two conditions are related, what signs to watch for, and how you and your healthcare team can work together to manage your health.

What Is Pulmonary Hypertension?

Pulmonary hypertension is a condition in which there’s high blood pressure in the pulmonary arteries, the blood vessels that carry unoxygenated blood from the heart to the lungs. If the pulmonary arteries are under high pressure, the right side of the heart must work harder to pump blood to the lungs. The overworked heart muscle becomes enlarged and can’t pump as effectively.

PH is different from systemic hypertension, which you likely think of when you hear “high blood pressure.” High blood pressure affects your entire body. PH, on the other hand, is limited to the arteries that carry blood to your lungs. Normal pulmonary arterial pressure is much lower than the blood pressure in the rest of your body — typically, 11 to 20 millimeters of mercury (mm Hg).

After the blood is pumped around the body to give oxygen to all the organs, it returns to the right side of the heart. The right side of the heart then pumps the blood to the lungs to pick up oxygen again.

If you have sleep apnea and notice any of these symptoms, tell your healthcare provider. These symptoms don’t necessarily mean you have PH, but it’s good to let your doctor know what’s going on so they can get to the root of your symptoms.

What Causes Pulmonary Hypertension?

There are five categories of pulmonary hypertension, and they’re grouped based on what causes them. They include:

1. Pulmonary Arterial Hypertension

With this type of PH, there’s a narrowing of the pulmonary arteries, and it’s called pulmonary arterial hypertension (PAH). PAH may be hereditary (passed down from parent to child) or due to illicit drug use (such as methamphetamine), congenital (present at birth) heart defects, or other health conditions.

2. Left-Sided Heart Disease

This type of pulmonary hypertension is caused by conditions that increase the workload on the left side of the heart. These include left-sided heart failure or disease of the mitral or aortic valves, which are on the left side of the heart.

3. Lung Disease

PH caused by obstructive sleep apnea (OSA) fits into this category. But pulmonary fibrosis (scarring of the lungs), chronic obstructive pulmonary disease (COPD), and spending prolonged periods of time at high altitudes can also lead to this type of PH.

4. Blockages in the Lungs

Untreated blood clots in the lungs or a tumor that presses on the pulmonary arteries can lead to this type of PH.

5. Other Health Conditions

This type of PH is caused by blood disorders like polycythemia vera and essential thrombocytopenia, inflammatory disorders like sarcoidosis, and kidney disease. Conditions that prevent the body from breaking down certain sugars, such as glycogen storage disease, can also cause this type of PH.

What’s the Connection Between Pulmonary Hypertension and Sleep Apnea?

Over time, untreated obstructive sleep apnea can lead to pulmonary hypertension. OSA happens when your airway becomes blocked during sleep, making it hard for air to reach your lungs. This blockage causes you to stop breathing for short periods, which means your body doesn’t get the oxygen it needs. When your lungs don’t get enough oxygen, the blood vessels in your lungs tighten. If this happens over and over, it can put extra pressure on those blood vessels, eventually leading to PH.

Obstructive sleep apnea doesn’t always cause pulmonary hypertension. If you have sleep apnea, you can reduce your risk of pulmonary hypertension by getting appropriate treatment for your sleep apnea. Treating OSA will help reduce the strain on your lungs and pulmonary arteries and prevent the development of PH.

Diagnosing Pulmonary Hypertension With Sleep Apnea

If you have OSA, your doctor may watch for signs of pulmonary hypertension, especially if you experience symptoms like shortness of breath, fatigue, chest pain, or swelling in your legs. Diagnosing pulmonary hypertension usually starts with a physical exam and a review of your symptoms and medical history.

Your healthcare provider may order tests, such as an echocardiogram (an ultrasound of the heart), to check the pressure in your lung arteries and see how well your heart is working. Other tests might include blood tests, chest X-rays, CT scans of the chest, electrocardiograms, or even a right heart catheterization, which directly measures blood pressure in the lungs. These tests help your care team find out if pulmonary hypertension is present and guide them in planning the best treatment for you. If you have OSA and develop new or worsening symptoms, let your doctor know so you can be evaluated promptly.

Treating Pulmonary Hypertension With Sleep Apnea

If you have both pulmonary hypertension and obstructive sleep apnea, treating both conditions is important for your overall health. The good news is that controlling sleep apnea can help lower the strain on your heart and reduce the risk of PH getting worse.

The most common treatment for OSA is using a continuous positive airway pressure (CPAP) machine while you sleep. CPAP keeps your airway open, helps you breathe more easily, and ensures your body gets enough oxygen overnight. Studies show that using CPAP regularly can improve oxygen levels and may help lower high blood pressure in the lungs caused by OSA. Other OSA treatments include oral devices, lifestyle changes like weight loss and exercise, and surgery (in rare cases).

In addition to treating sleep apnea, your doctor may recommend specific treatments for pulmonary hypertension. These can include medications to relax blood vessels, reduce fluid buildup, or improve how your heart works. Lifestyle changes, such as eating a heart-healthy diet, staying active, and avoiding smoking, can also support your heart and lung health.

Managing these conditions often requires a team approach. Your sleep specialist, pulmonologist (lung doctor), and cardiologist (heart doctor) may work together to create a treatment plan tailored to your needs. Keeping up with your treatments, attending regular checkups, and letting your care team know about any new symptoms can help you live better with both OSA and PH.

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If you have OSA, have you also been diagnosed with PH? How do you manage both conditions? Let others know in the comments below.